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Enrolling with Paramount

Enrolling with Paramount? If your group has been through the quoting process and has decided to enroll with Paramount, we will need a few forms.

Ohio and Michigan Large Groups:

  • Implementation Page (provided by Paramount)
  • Product Selection Form 
  • Wage and Tax from the most recent quarter - mark each employees status (full time, part time, seasonal, etc.)
  • Applications from all enrolling employees
  • Waivers for employees that aren’t enrolling
  • First  months premium
  •  Ohio Employer Certification of Eligibility
  •  Michigan Employer Certification of Eligibility 
  • Common Ownership Certification.  

MEWA (checklist):

  •  MEWA Employer Master Application
  •  ODJFS (OBES) or Schedule C for Sole Proprietors- mark each employees status (full time, part time, seasonal, etc)
  •  Current carriers bill
  •  First month premium check
  •  Implementation Page
  • Ohio Employer Certificaiton of Eligibility
  • Common Ownership
  • Enrollment Applications
  • Employee Waivers
  • Proof of Chamber association

Ohio Small Group (ACA) (checklist):

  • Master Application
  • ODJFS (OBES) or Schedule C - mark each employees status (full time, part time, seasonal, etc.)
  • Current carriers bill
  • First  months premium
  • Implementation Page - found in Jet 
  • Disclaimers Page - found in Jet  
  • Group Pediatric Dental Attestation or Application 
  • Superior Vision Application   
  • Applications from all enrolling employees
  • Waivers for employees that aren’t enrolling
  • Alliance paperwork, if applicable
  • MEWA Enrollement

 Michigan Small Group (checklist):